GnRH拮抗剂与GnRH激动剂短方案IVF-ET结局的比较

Comparison between a GnRH antagonist and a GnRH agonist flare-up protocol on the outcome of patients who underwent in vitro fertilization

目的比较GnRH antagonist与GnR Hagonist短方案的IVF-ET结局。方法2006年8月至2007年8月GnR Hantagonist治疗组54人和GnR Hagonist短方案对照组132人,记录促性腺激素的用量及其用药天数、hCG日子宫内膜厚度和激素水平、获卵数、受精率、卵裂率、优胚率、妊娠率和OHSS发生率等指标。结果两组促性腺激素的用量及其用药天数、获卵数、受精率、卵裂率、着床率和妊娠率相比较均无显著差异(P>0.05)。GnR Hantagonist组在hCG日激素水平低,与对照组比较其差异有统计学意义。结论行GnR Hantagonist方案IVF-ET助孕治疗与传统的GnR Hagonist短方案比较,其hCG日雌激素水平下降可能是OHSS发生率显著下降的主要因素;但卵泡的发育、卵母细胞的受精率、卵裂率及妊娠率和着床率均不受影响。GnR Hantagonist的使用为IVF-ET助孕药物提供了一种新的选择。

Objective： To compared with the effect of the protocol of gonadotropin releasing hormone antagonist and the flare -up protocol of gonadotropin releasing hormone agonist on the outcome of patients who underwent in vitro fertilization. Methods ： Referred patients who subjected to IVF between August 2006 and August 2007 were divided into two group： the study group： 54 patients were subjected to a protocol of gonadotropin -releasing hormone antagonist. The control group： 132 patients were subjected to a flare -up protocol of gonadotropin - releasing hormone agonist. To record the doses of gonadotrophins （ HMG and/or rFSH）, the during of administration, the thickness of endometrium and the profile of hormone level on the day of HCG administration, the number of retrieved oocyte, the ratio of fertilization, the ratio of cleavage, the ratio of the good quantity embryos, implantation rate of embryo, pregnancy rate and the incidence rate of OHSS. Results ： The two groups were similar with respect to the doses of gonadotrophins （ HMG and/or rFSH）, the duration of administration, the number of oocyte retrieval, the ratio of fertilization, the ratio of cleavage, implantation rate of embryo and the pregnancy rate （ P 〉 0. 05）. Significant differences were found regarding the profile of hormone by analyzing statistically. Conclusion ： We demonstrated that GnRH antagonist administration in patients undergoing IVF with the profile of serum E2 was reduced significantly, which decreased the incidence of OHSS. But did not impact the development of follicle and alter the oocyte competence, the ratio of cleavage, implantation rate of embryo and the pregnancy rate. These result demonstrated that the administration of GnRH antagonist provided a new option for patients who undergoing IVF on controlled ovarian stimulation protocol.